Unseen and underserved: the first multifactorial assessment of mental health among Paraguayan male prisoners.

BACKGROUND

This study provides the analysis of mental health among incarcerated men in Paraguay from a representative sample of 621 adult prisoners in two major penitentiaries.

AIMS: To assess the prevalence and correlates of psychiatric symptoms, suicide risk, and substance use among incarcerated men, and their associations with sociodemographic, penal, and health-related factors.

METHODS

We employed the Symptom Checklist-90-R (SCL-90-R), the Columbia-Suicide Severity Rating Scale (C-SSRS Screener), and the MULTICAGE CAD-4 for alcohol and substance use. We assessed the prevalence and statistical associations between psychiatric symptoms and relevant variables.

RESULTS

Findings revealed substantial levels of psychoticism (28.2%) and phobic anxiety (25.4%). Specifically, nearly one in five participants exhibited suicide risk (19.5%), and problematic drug and alcohol use were identified in 57.0% and 44.9% of users, respectively. Statistically significant associations were observed between SCL-90-R symptom dimensions and variables including suicide risk, prior mental health diagnoses, substance use, and access to treatment. Symptom severity was also associated with pre-incarceration socioeconomic vulnerability and legal status.

CONCLUSION

The results underline the need for early psychiatric screening, care pathways, and integrated carceral mental health systems to address psychiatric morbidity among incarcerated men in Paraguay.